Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Dr Miles Davidson on 14 October 2015. During that inspection we found that a disclosure and barring service (DBS) check had not been obtained for certain staff who acted as chaperones. Also, the practice had not obtained all employment checks required by law in regards to four staff files we checked. 

Overall the practice was rated as good with are services safe requiring improvement in view of the above. After the comprehensive inspection, the practice wrote to us to say what action they had taken to meet the legal requirement in relation to the above breach.

We undertook this desk based review on 21 October 2016 to check that the provider had completed the required improvements, and now met the legal requirement. We did not visit the practice as part of this inspection.

This report only covers our findings in relation to the above requirement. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Dr Miles Davidson on our website at www.cqc.org.uk.

Our finding across the area we inspected was as follows:

• The practice had taken appropriate action to meet the legal requirement.
• The chaperone policy had been updated to require that an appropriate Disclosure and Barring Service (DBS) check is obtained for all staff who act as a chaperone.

• Effective recruitment procedures were in place to ensure the required employment checks and information is obtained prior to staff

  working at the practice.

• The practice had obtained an appropriate Disclosure and Barring Service (DBS) check for all staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Stubley Medical Centre (Dr Miles Davidson) on 14 October 2015. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• The practice had excellent purpose-built facilities and was well-equipped to treat patients and meet their needs
• The practice had been one of the lowest users of the out of hours’ service within the CCG over the last three years, and hospital admissions were also amongst the lowest despite the demographics of their patient profile (higher number of older patients and higher disease prevalence rates)
• Patients said they were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.

• There was a clear leadership structure and staff felt supported by management. There was evidence that staff worked together well as a team and proactively engaged with the wider multi-disciplinary team to improve patient care.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and further training needs had been identified. Staff were supported to develop their skills and knowledge.

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. However, there was not a consistent approach in how incidents were reported, although learning points were shared with the wider practice team .
• Risks to patients were generally assessed and well managed, with the exception of those relating to recruitment checks.
• Data showed patient outcomes were generally above average for the locality.
• The practice held regular meetings but these were not always documented to reflect discussions and demonstrate outcomes.
• Urgent appointments were available on the day they were requested. However, patients told us that they sometimes had to wait a long time for non-urgent appointments.
• Information on making a complaint was not readily available, and verbal complaints were not always reviewed. However, we did see evidence that learning had been applied from written complaints.

We saw two areas of outstanding practice:

• The practice had a designated champion for frail and older people. The role ensured patients could access help and care rapidly to meet their needs, allowing them to remain in their own home. This was achieved via a co-ordinated multi-disciplinary approach focussed upon a holistic and caring patient-centred approach.
• The proactive approach to more complex patients had reduced the number of hospital admissions and A&E attendances. The practice also had the lowest rate of emergency admissions for patients experiencing poor mental health.

There were areas of practice where the provider needs to make improvements.

The areas where the provider must make improvements are:

• Ensure recruitment arrangements include all employment checks required by law for all staff.
• Ensure that a Disclosure and Barring Service check has been completed for all clinical staff and any non-clinical staff acting as chaperones.

In addition the provider should:

• Improve the availability of non-urgent appointments.
• Review the systems for complaints by making information on complaints more easily accessible to patients. Ensure that all verbal complaints are recorded.
• Implement one approach to the recording of significant events by the use of a specified template.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice